基于“实则阳明,虚则太阴”从肠道微环境防治血管性痴呆  

Prevention and Treatment of Vascular Dementia from Intestinal Microenvironment Based on"Excess Syndrome of Yangming Disease and Deficiency Syndrome of Taiyin Disease"

作　　者：贺艳荟 王雪茜[1] 程发峰[1] 李长香[1] HE Yanhui;WANG Xueqian;CHENG Fafeng;LI Changxiang(Beijing University of Chinese Medicine,Beijing China 100029)

机构地区：[1]北京中医药大学,北京100029

出　　处：《中医学报》2025年第3期542-546,共5页Acta Chinese Medicine

基　　金：燕京刘氏伤寒流派传承工作室项目(1190062620092)。

摘　　要：阳明病、太阴病源于《伤寒论》,结合柯韵伯提出的“实则阳明,虚则太阴”对血管性痴呆的发病和进展进行探讨可知,血管性痴呆从其发病过程中所体现的肠道微环境失调这一关键病理因素,以及结合其所表现的证候特点,或可属于阳明病和太阴病。因此从阳明、太阴入手进行治疗,结合“上气不足,下气有余”理论,以通降药物顺应肠腑,以补气升清药物助脾升清,可使肠道生态恢复平衡稳态,脑窍得以恢复滋养,则可预防卒中后血管性痴呆的发生或延缓血管性痴呆的进展。Yangming disease and Taiyin disease was first proposed in Treatise on Typhoid Fever.Combined with Ke Yunbo′s proposal of"excess syndrome of Yangming disease and deficiency syndrome of Taiyin disease",vascular dementia may belong to the category of"Yangming disease and Taiyin disease"in terms of its pathogenesis,which reflects the dysregulation of intestinal microenvironment as a key pathological factor,and its syndrome manifestation of Yangming disease and Taiyin disease.Therefore,the treatment should be from the perspective of Yangming disease and Taiyin disease,combined with the theory of"insufficiency of upper Qi and excess of lower Qi",can prevent the occurrence of post-stroke vascular dementia or delay the progression of vascular dementia by using the medicines that can descend Qi to conform to the Qi of intestines,and by using the medicines function in tonifying ascending clear Qi to help the Spleen Qi ascending,so that the ecology of intestinal tract can restore the balance of the steady state.If the brain orifices can be restored and nourished,the occurrence of vascular dementia after stroke can be prevented or the progression of vascular dementia can be delayed.

关 键 词：血管性痴呆 “实则阳明 虚则太阴” 肠道微环境 阳明蓄血 太阴脾虚 

分 类 号：R259[医药卫生—中西医结合]